Healthcare Provider Details

I. General information

NPI: 1902731219
Provider Name (Legal Business Name): CHRISTOPHER JORGE GONZALES PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19119 N CREEK PKWY STE 107
BOTHELL WA
98011-8023
US

IV. Provider business mailing address

2001 BUTTERFIELD RD STE 1600
DOWNERS GROVE IL
60515-1211
US

V. Phone/Fax

Practice location:
  • Phone: 425-486-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number70076105
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: